What causes hemolytic anemia in dogs

what causes hemolytic anemia in dogs

Anemia in Dogs

What causes autoimmune hemolytic anemia? AIHA may be primary (idiopathic) or it may be secondary. With primary AIHA, the dog's immune system is not working properly, and it incorrectly makes antibodies that target its own red blood cells. In dogs, it is estimated that . Hemolytic Anemia in dogs is a condition in which affected dogs’ immune system fights and destroys typically healthy red blood cells. This condition can be a primary condition or be a result of a secondary, or underlying illness.

Helicobacter pyloripreviously known as Campylobacter pyloriis a gram-negativemicroaerophilicspiral helical bacterium usually found in the stomach.

The bacterial infection has also been proposed to have protective effects for its hosts against infections by how to apply for sss pathogensasthmaobesity[16] celiac diseaseinflammatory bowel disease[17] rhinitisatopic dermatitis[19] gastroesophageal reflux disease[20] and esophageal cancer.

Some studies suggest that H. Less common ulcer symptoms include nausea, vomiting, and loss of appetite. Bleeding in the stomach can also occur as evidenced by the passage of black stools ; prolonged bleeding may cause anemia leading to weakness and fatigue. If bleeding is heavy, hematemesishematocheziaor melena may occur.

Inflammation of the pyloric antrumwhich connects the stomach to the duodenumis more likely to lead to duodenal ulcers, while inflammation of the corpus i. Usually, these polyps are asymptomatic but gastric polyps may be the cause of dyspepsia, heartburn, bleeding from the upper gastrointestinal tract, and, rarely, gastric outlet obstruction [32] while colorectal polyps may be the cause of rectal bleeding, anemia, constipation, diarrhea, weight loss, and abdominal pain.

Individuals with chronic H. It is capable of forming biofilms [40] and can convert from spiral to a possibly viable but nonculturable coccoid form. Helicobacter pylori has four to six flagella at the same location; all gastric and enterohepatic Helicobacter species are highly motile owing to flagella. Helicobacter pylori is microaerophilic — that is, it requires oxygenbut at lower concentration than in the atmosphere. It contains a hydrogenase that can produce energy by oxidizing molecular hydrogen H 2 made by intestinal bacteria.

The other four families are porinsiron transporters, flagellum -associated proteins, and proteins of unknown function. Like other typical Gram-negative bacteria, the outer membrane of H. The O antigen of LPS may be fucosylated and mimic Lewis blood group antigens found on the gastric epithelium. Helicobacter pylori consists of a large diversity of strains, and hundreds of genomes have been completely sequenced.

The pan-genome, that is a combined set of 30 sequenced strains, encodes 2, protein families orthologous groups, OGs. Among them, what helps to bring on labor, OGs are conserved in all the 30 strains, and represent the universal core.

The remaining OGs correspond to the accessory genome in which OGs are unique i. InSharma et al. Untilonly about 55 transcriptional start sites TSSs were known in this species. Study of the H. Two of sequenced strains have an around 40 kb -long Cag pathogenicity island a common gene sequence believed responsible for pathogenesis that contains over 40 genes. This pathogenicity island is usually absent from H.

The cagA gene codes for one of the major H. Bacterial strains with the cagA gene are associated with an ability to cause ulcers. The cag pathogenicity island PAI has about 30 genes, part of which code for a complex type IV secretion system. The low GC-content of the cag PAI relative to the rest of the How to become a it girl genome suggests the island was acquired by horizontal transfer from another bacterial species.

The What is a sophomore in college protein enables the bacterium to transmigrate across the host cells' epithelium, and is also needed for the translocation of CagA. The vacA Q gene codes for another major H.

To avoid the acidic environment of the interior of the stomach lumenH. This also keeps the bacteria from being swept away into the lumen with the bacteria's mucus environment, which is constantly moving from what causes hemolytic anemia in dogs site of creation at the epithelium to its dissolution at the lumen interface. One such adhesin, BabA, binds to the Lewis b antigen displayed on the surface of stomach epithelial cells.

It has been proposed that BabA's acid responsiveness enables adherence while also allowing an effective escape from unfavorable environment at pH that is harmful to what causes hemolytic anemia in dogs organism. In addition to using chemotaxis to avoid areas of low pH, H.

These react with the strong acids in the environment to produce a neutralized area around H. In fact, urease expression is not only required for establishing initial colonization but also for maintaining chronic infection. As mentioned above, H. Helicobacter pylori arginase, a bimetallic enzyme binuclear Mn2-metalloenzyme arginase, crucial for pathogenesis of the bacterium in human stomach, [66] a member of the ureohydrolase family, catalyzes the conversion of L-arginine to L-ornithine and urea, where ornithine is further converted into polyamines, which are essential for various critical metabolic processes.

This provides acid resistance and is thus important for colonization of the bacterium in the gastric epithelial cells. Arginase of H. Alterations in the availability of L-arginine and its metabolism into polyamines contribute significantly to the dysregulation of the host immune response to H.

Helicobacter pylori what causes hemolytic anemia in dogs the stomach and duodenal linings by several mechanisms. The ammonia produced to regulate pH is toxic to epithelial cells, as are biochemicals produced by H.

Colonization of the stomach by H. Helicobacter cysteine-rich proteins Hcpparticularly HcpA how to make free phone calls from internet in indiaare known to trigger an immune response, causing inflammation. Ulcers thats what you get tab the stomach and duodenum result when the consequences of inflammation allow stomach acid and the digestive enzyme pepsin to overwhelm the mechanisms that protect the stomach and duodenal mucous membranes.

The location of colonization of H. The inflammatory response caused by bacteria colonizing near the pyloric antrum induces G cells in the antrum to secrete the hormone gastrinwhich travels through the bloodstream to parietal cells in the fundus. When H. This also may increase the risk of stomach cancer. The pathogenicity of H. The injected peptidoglycan is recognized by the cytoplasmic pattern recognition receptor immune sensor Nod1, which then stimulates expression of cytokines that promote inflammation.

The type-IV secretion apparatus also injects the cag PAI-encoded protein CagA into the stomach's epithelial cells, where it disrupts the cytoskeletonadherence to adjacent cells, intracellular signaling, cell polarityand other cellular activities.

A C-terminal region of the CagA protein amino acids — has also been suggested to be able to regulate host cell gene transcriptionindependent of protein tyrosine phosphorylation. Two related mechanisms by which H. One mechanism involves the enhanced production of free radicals near H. The other proposed mechanism has been called a "perigenetic pathway", [79] and involves enhancement of the transformed host cell phenotype by means of alterations in cell proteins, such as adhesion proteins.

The strain of H. Strains of H. As a result of the bacterial presence, neutrophils and macrophages set up residence in the tissue to fight the bacteria assault. Infection by H. More than half of gastric cancer patients have lymph node metastasis when they are initially diagnosed. The gastritis caused by H. As reviewed by Santos and Ribeiro [95] H.

In particular, Raza et al. The pathogenesis of H. This oxidative stress response induces potentially lethal and mutagenic oxidative DNA adducts in the H. Vulnerability to oxidative stress and oxidative DNA damage occurs commonly in many studied bacterial pathogens, including Neisseria gonorrhoeae, Hemophilus influenzae, Streptococcus pneumoniae, S.

Thus, transformation and recombinational repair appear to contribute to successful infection. Transformation the transfer of DNA from one bacterial cell to another through the intervening medium appears to be part of an adaptation for DNA repair.

While many organisms are competent only under certain environmental conditions, such as starvation, H. In particular, natural transformation is increased by DNA damage in H. RuvC protein is essential to the process of recombinational repair, since it resolves intermediates in this process what grandma says grandma does auto glass Holliday junctions.

Colonization with H. Noninvasive tests for H. An endoscopic biopsy is an invasive means to test for H. Low-level infections can be missed by biopsy, how to stop installing device driver software multiple samples are recommended. The most accurate method for detecting H. Helicobacter pylori is contagious, although the exact route of transmission is not known. Consistent with these transmission routes, the bacteria have been isolated from fecessalivaand dental plaque of some infected people.

Findings suggest H. Due to H. Furthermore, development of a vaccine against H. Many investigations have attempted to prevent the development of Helicobacter pylori -related diseases by eradicating the bacterium during the early stages of its infestation using antibiotic-based drug regimens. Studies find that such treatments, when effectively eradicating H. However studies disagree on the ability of these treatments to alleviate the more serious histopathological abnormalities in H.

A meta-analysis i. These results agreed with a retrospective cohort study done in Japan and published in [16] as well as a meta-analysisalso published inof 24 studies conducted on individuals with varying levels of risk for developing the disease.

In all events, studies agree that antibiotic-based regimens effectively reduce the occurrence of metachronous H. It is suggested that antibiotic-based drug regimens be used after resecting H. Superficial gastritis, either acute or chronic, is the most common manifestation of H. The signs and symptoms whatever happens in life quotes this gastritis have been found to remit spontaneously in many individuals without resorting to Helicobacter pylori eradication protocols.

The H. Various antibiotic plus proton pump inhibitor drug regimens are used to eradicate the bacterium and thereby successfully treat the disorder [] with triple-drug therapy consisting of clarithromycinamoxicillinand a proton-pump inhibitor given for 14—21 days often being considered first what is jumbo loan in california treatment.

Once H. The standard first-line therapy is a one-week "triple therapy" consisting of proton-pump inhibitors such as omeprazole and the antibiotics clarithromycin and amoxicillin. Previously, the only option was symptom control using antacidsH 2 -antagonists or proton pump inhibitors alone.

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Hemolytic anemia results from loss of RBCs. Immune-mediated destruction is the most common cause in dogs, although infections, tumors, and other causes also occur. Immune-mediated hemolytic anemia is treated with immunosuppressive drugs. Other types are treated by addressing the underlying cause. Immune?mediated hemolytic anemia (IMHA) causes severe anemia in dogs and is associated with considerable morbidity and mortality. Treatment with various immunosuppressive and antithrombotic drugs has been described anecdotally and in previous studies, but little consensus exists among veterinarians as to the optimal regimen to employ and maintain after diagnosis of the disease. Sometimes, the causes of hemolytic anemia are unclear, but they can include: An attack by your immune system, as with lupus. This can happen to anyone, even a baby still in the womb or a newborn.

Anemia occurs when there is a decrease in the number of red blood cells, which can be measured by red blood cell count or hemoglobin concentration.

It can develop from loss, destruction, or lack of production of red blood cells. Anemia is classified as regenerative or nonregenerative. In a regenerative anemia , the bone marrow responds appropriately to the decreased number of red blood cells by increasing production of new blood cells. In a nonregenerative anemia , the bone marrow responds inadequately to the increased need for red blood cells.

Anemias due to bleeding or the destruction of existing red blood cells are usually regenerative. Anemias that are caused by a decrease in the hormone that stimulates red blood cell production or by an abnormality in the bone marrow are nonregenerative. The signs of anemia in animals depend on the severity, the duration short or long-term , and the underlying cause of the illness. Sudden anemia can result in shock and even death if more than a third of the blood volume is lost rapidly and not replaced.

After rapid blood loss, the animal usually has an increased heart rate, pale gums, and low blood pressure. The cause of the blood loss may be obvious, for example, a major injury.

If no evidence of external bleeding is found, your veterinarian will look for a source of internal or hidden blood loss, for example, a ruptured tumor on the spleen, a stomach ulcer, a bleeding disorder, or parasites.

If red blood cells are being destroyed, the animal may appear jaundiced a yellowish color of the whites of the eyes, skin, or gums. Animals with long-term anemia have had time to adjust, and their signs are usually slower to develop.

These include loss of energy, weakness, and loss of appetite. Affected animals will have similar physical examination findings, such as pale gums, an increased heart rate, and possibly enlargement of the spleen or a heart murmur. A complete medical history is an important part of diagnosing anemia. Questions a veterinarian may ask include how long signs have been present; if there is a history of exposure to toxins such as rodent poisons, heavy metals, or toxic plants; what drug treatments and vaccinations the pet has had; where the pet has traveled; and any prior illnesses.

A complete blood count is another diagnostic tool your veterinarian will use to provide information on the severity of the anemia, the degree of bone marrow response, and the condition of other types of blood cells. A test should be performed to evaluate red blood cell size and shape and to check for red blood cell parasites some of which are discussed later in this chapter.

A blood sample is taken and placed in a test tube containing an anticoagulant to stop it from clotting. It is then transported to a laboratory. The process is generally done using automated equipment. The blood is well mixed and placed on a special rack on the analyzer.

This instrument has many different components to analyze different elements in the blood. The cell counting component counts the numbers of red and white blood cells and platelets. The results are printed out or sent to a computer for review by a technician. Because an automated cell counter samples and counts so many cells, the results are very precise.

However, certain abnormal cells in the blood may be identified incorrectly. To be sure the results are correct, a technician reviews the blood smear on a slide and identifies any abnormal cells or blood parasites present.

In addition to counting, measuring, and analyzing red blood cells, white blood cells, and platelets, automated blood analyzers also measure the average size and the amount of hemoglobin in red blood cells.

This information can be helpful when trying to identify the cause of an anemia. Additional blood and urine tests can be used to evaluate how well the internal organs are functioning.

X-rays can help identify hidden disease, such as a penny in the stomach of a puppy leading to zinc poisoning and anemia. If hemolytic disease a condition in which there is destruction of red blood cells is suspected, other tests can be performed. A blood test for infectious agents may also be helpful in defining the cause of anemia. Bone marrow evaluation is typically done for any animal with an unexplained, nonregenerative anemia.

Sampling the bone marrow requires sedation or anesthesia. Obvious causes of severe loss include major injury or surgery. Internal parasites, such as hookworms in dogs, can lead to severe blood loss, especially in puppies. Low-grade, longterm blood loss eventually results in iron-deficiency anemia. This leads to abnormally small red blood cells and a lack of hemoglobin. In young animals this is often caused by parasites for example, fleas, lice, or intestinal worms , but in older animals, bleeding from stomach ulcers or tumors is more common.

Hemolytic anemias occur when red blood cells are destroyed. They are usually regenerative. Toxins, red blood cell trauma, infections, immune system defects, and red blood cell membrane defects can all cause hemolytic anemias.

In dogs, the most common cause of hemolytic anemia is immune mediated. This type of anemia can occur on its own or as a result of tumors, infection, drugs, or vaccinations. The body no longer recognizes red blood cells as self and develops antibodies to circulating red blood cells, leading to their destruction. Dogs with immune-mediated hemolytic anemia are usually jaundiced, sometimes have a fever, and may have an enlarged spleen.

They can show mild, slow-developing signs and not appear to be in any pain, or they can suddenly be in severe crisis. Any underlying infections will be treated and unnecessary drug therapy discontinued. Intravenous fluid therapy may be started and supplemented with blood transfusions if necessary. Drugs are also given to suppress the immune system in order to stop the destruction of red blood cells.

Blocking of a blood vessel in the lungs by a piece that has broken away from a blood clot known as pulmonary thromboembolism is a risk for dogs with immune-mediated hemolytic anemia. The underlying cause is unknown, but the risk may be reduced by supportive care with fluids and blood transfusions. Fluids are important to keep kidneys functioning properly and to protect the kidneys from the high concentrations of circulating bilirubin the reddish yellow pigments in blood that cause jaundice.

If the risk for forming blood clots is high, anticoagulant medication may also be given. The risk of death depends on which signs are seen, but rapid drops in red blood cell counts, moderate to high white blood cell counts, abnormal bruising, and excessive clotting may indicate a higher risk. Your pet's veterinarian may need to refer your dog to an internal medicine specialist.

Alloimmune hemolysis occurs when antibodies attack red blood cells of another individual of the same species. Neonatal isoerythrolysis is an example of such a disease and is seen rarely in dogs. The antibodies develop in the mother during unmatched blood transfusions. Newborns with neonatal isoerythrolysis are normal at birth but develop severe hemolytic anemia within 2 to 3 days and become weak and jaundiced. A veterinarian can perform tests to confirm the diagnosis.

Treatment consists of stopping any colostrum while giving supportive care with transfusions. A veterinarian can perform a test to check for alloimmune hemolysis before the newborn is allowed to receive maternal colostrum. Microangiopathic hemolysis occurs when red blood cells are damaged due to turbulent flow through abnormal blood vessels.

It can be seen in dogs with severe heartworm infections, blood vessel tumors for example, hemangiosarcoma , twisting of the spleen, and disseminated intravascular coagulation, a condition in which small blood clots develop throughout the bloodstream, blocking small blood vessels and depleting the platelets and clotting factors needed to control bleeding. Treatment requires correcting the underlying disease.

A deficiency of phosphorus in the blood, leading to destruction of red blood cells, is seen in dogs with diabetes, hepatic lipidosis a disorder of fat metabolism in the liver , and refeeding syndrome chemical and fluid abnormalities that occur during recovery from fasting or starvation.

Providing additional phosphorus, either by mouth or by injection depending on the severity of the illness, is the recommended treatment. Many classes of drugs can cause anemia if they are ingested accidentally or if their prescribed use is not closely monitored. These include common human and animal drugs, such as acetaminophen , aspirin , naproxen , penicillin, and many other antibiotic and antiparasitic agents.

Other anemia-causing toxins include plants such as oak, red maple, and bracken fern; foods such as fava beans and onions; chemicals; and heavy metals such as copper, lead, selenium , and zinc.

It is always important to give as complete a history as possible to the veterinarian when anemia is suspected, in order to help pinpoint the cause. Many infections—caused by bacteria, viruses, or other organisms—can lead to anemia, by direct damage to red blood cells leading to their destruction or by effects on the elements that produce red blood cells in the bone marrow. In dogs, for example, infections involving certain organisms in the genuses Ehrlichia and Babesia are known to cause anemia.

Several inherited red blood cell disorders cause anemia. Phosphofructokinase enzyme deficiency occurs in English Springer Spaniels. Deficiencies in these enzymes lead to shortened red blood cell life span and a regenerative anemia. In dogs with phosphofructokinase deficiency, the sudden destruction of red blood cells is caused by a high blood pH created after excessive excitement or exercise. If such situations are minimized, these dogs may have a normal life expectancy.

There is no treatment for pyruvate kinase deficiency, and affected dogs will have a shortened life span due to abnormalities of the bone marrow. Nonregenerative anemias can be caused by nutritional deficiencies, chronic disease, kidney disease, or bone marrow diseases. Nutritional deficiency anemias develop when the nutrients needed for red blood cell formation are not present in adequate amounts.

Anemia develops gradually and may initially be regenerative, but ultimately becomes nonregenerative. Starvation causes anemia by a combination of vitamin and mineral deficiencies as well as a negative energy and protein balance. The deficiencies most likely to cause anemia are iron, copper, vitamin B 1 2 , vitamin B 6 , riboflavin, niacin , and vitamin E.

Iron deficiency is the most common deficiency seen in dogs. It is rarely nutritional in origin—it most commonly occurs after blood loss see Anemia in Dogs : Blood Loss Anemia. Young animals do not have much stored iron, and milk contains very little iron. Your veterinarian may recommend oral iron supplements for anemic newborns. Your veterinarian will also look for any hidden source of blood loss and treat it if needed.

B vitamin deficiencies are rare. Some drugs, such as anticonvulsants and drugs that interfere with B vitamin metabolism, may cause anemia. Poor absorption of vitamin B 12 has been reported in Giant Schnauzers. These dogs respond to injections of vitamin B Anemia caused by a longterm chronic disease is usually classified as mild to moderate and nonregenerative.

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